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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8703
Experience:  Doctor of Medicine
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Looking for an opinion from a rheumatologist My osteo arthritis

Customer Question

Looking for an opinion from a rheumatologist

My osteo arthritis has reached a point where I need to take anti inflammatories, made more necessary by a failing hip which will be replaced in Sept

I have had odd liver enzyme changes (blood tests currently OK). I have been prescribed Motifene

My question is what drug is the most gentle on the liver, the trad family of anti inflams affecting Cox-1 and Cox-2 or the new Cox-2 inhibitors
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.
Hi there.
Thank you for your question.
Would you like me to help you out with your question?
Customer: replied 2 years ago.

yes

Expert:  Dr. SH replied 2 years ago.
Overall, liver enzyme changes with NSAIDs are quite rare. So most of these drugs are safe with respect to the liver.
In a study done in 2006 it was found that bromfenac, nimesulide, sulindac, and diclofenac had higher proportions of reports of liver disorders compared with those of other NSAIDs.

Here is a link where you can read for yourself:

http://www.ncbi.nlm.nih.gov/pubmed/16982289

However the more important side effect with these NSAIDs especially the ones that inhibit COX 1 and COX 2 are stomach problems i.e. ulcers in the stomach, inflammation in the stomach, bleeding. Also kidney problems can happen with various NSAIDs.
Using simple analgesics such as paracetamol (acetaminophen) is safer than using things like diclofenac especially when one is intending to use them for a long period of time as your case may be.
COX 2 inhibitors like celecoxib are safer in regards to stomach toxicity which are also commonly used for longterm management of pains of osteoarthritis.

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